Hip Labrum Repair and Reconstruction

Hip Labrum Repair and Reconstruction

What is the hip labrum?

The hip is a ball and socket joint that allows a wide range of motion so that the human body is able to walk, run, climb stairs and perform everyday activities. The hip labrum is a protective rim of soft tissue or fibrocartilage found in the hip joint that provides stability, cushioning and full range of motion. The hip labrum also deepens the socket in joint, acting as a rubber seal or gasket which holds the ball at the top of the femur (thigh bone) firmly within the hip socket.

What is a hip labrum tear?

A hip labral tear involves the ring of cartilage that lines the outside rim of the hip socket. When this cartilage becomes torn or damaged, known as a labral tear, arthroscopic labrum surgery may be necessary to return patients to their active, pain-free lifestyle. Dr. Benedict Nwachukwu, orthopedic hip surgeon, is highly trained and experienced at treating labral tears for patients in Manhattan, New York City and the surrounding New York boroughs.

What causes the labrum in the hip to tear?

A labral tear can occur from repetitive pivoting or twisting motions, such as in golf, hockey, soccer, ballet and football. Excessive wear-and-tear to the labrum caused by abnormalities in the hip joint can also lead to a labrum tear.

What are the symptoms of a labrum tear?

Many hip labrum tears do not cause any symptoms. On occasion however, patients experiencing a labral tear report the following symptoms:

• Pain in the hip or groin
• Locking or catching sensation in the hip joint
• Clicking or popping in the joint with movement
• Decreased or limited range of motion in the joint
• Stiffness

How is a hip labrum tear diagnosed?

Dr. Nwachukwu will assess the hip joint by conducting a physical examination, as well as obtaining an x-ray or an MRI to examine the inside of the hip joint in detail. Initial treatment is typically conservative and may include pain relievers, physical therapy, activity modification and hip joint injection. If these measures fail to resolve symptoms over a specified period of time, Dr. Nwachukwu will treat the tear using an arthroscopic surgical approach.

Arthroscopic View of Torn Hip Labrum

What is arthroscopic surgery for a torn labrum?

Arthroscopic hip surgery to repair a torn labrum is the gold-standard of care and the best choice among top surgeons like Dr. Nwachukwu. Arthroscopic repair is done inside the joint through small incisions, using a small camera called an arthroscope. Small surgical instruments are also inserted to allow Dr. Nwachukwu to repair the labrum. Depending on the amount of damage, Dr. Nwachukwu may use a surgical technique called labral debridement. During this procedure, labral debridement is achieved by trimming back the areas where the labral tear occurred, cleaning up jagged cartilage and creating a smooth surface. In cases where extensive injury has occurred and the labrum is repairable, Dr Nwachukwu will perform a hip labral repair.

What is a hip labrum repair?

The goal of a hip labrum repair is to reattach the torn labrum to the acetabulum (the bowl-shaped socket in the pelvis). During this procedure, Dr. Nwachukwu will use small anchors and strong sutures to secure the labrum firmly into its correct anatomical position within the joint socket. This type of repair restores the seal around the hip joint, reduces pain and improves joint function.

If the patient is also suffering from a condition called hip impingement syndrome, Dr. Nwachukwu will check for any bone abnormalities and will correct them during surgery using a special tool to reshape the surface of the bone.

What is hip labrum reconstruction?

Some labral tears are large and complex in nature and may not be amenable to repair or debridement. Patients in New York who have a labrum that is severely damaged or degenerated and cannot be repaired may require a labral reconstruction. During this specialized procedure, Dr. Nwachukwu uses a graft either from the patient (called an autograft) or from a donor cadaver (called an allograft). The labrum is rebuilt with the goal of restoring the functional anatomy of the original labrum. This will restore the normal function of the hip while preventing further damage to the articular cartilage of the hip.

What are the risks of arthroscopic hip surgery?

During a traditional hip arthroscopy, the hip joint needs to be open in order for the instruments to safely pass into the joint. The traditional way to open the joint is to place a large padded post in the patient’s perineal area to provide counter-traction while the leg is pulled taught. Dr. Nwachukwu is one of approximately 20% of hip surgeons in the USA  who have switched to postless hip arthroscopy.  This new technology for accessing the joint eliminates the perineal post completely by using a special surgical table to create the traction required for the surgery resulting in quicker recovery without complications such as numbness in the genital area and possible nerve damage.

Learn more about postless hip arthroscopy.

How long is the recovery after hip labrum repair or reconstruction?

Recovery time following a hip labrum repair or reconstruction will depend primarily on the complexity of the surgery. A labrum reconstruction may take longer to heal than a debridement or repair. Following arthroscopic surgery, Dr. Nwachukwu will give his patient a detailed rehabilitation protocol and the patient will partner with a skilled physical therapist to regain normal hip function and strength. Generally, most athletes who undergo a hip labrum repair are able to return to sport within 6-8 months.

For more information on the treatments available for a torn hip labrum and on arthroscopic hip labrum repair and reconstruction, please contact the office of Benedict Nwachukwu, MD, orthopedic hip surgeon serving Manhattan, New York City and surrounding New York boroughs.